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01.
arXiv (CS.CL) 2026-06-11

Compatibility-Aware Dynamic Fine-Tuning for Large Language Models

Supervised Fine-Tuning (SFT) is the predominant paradigm for aligning large language models (LLMs), yet it suffers from optimization instability and limited generalization. Recent work attributes this issue to pathological gradient scaling and proposes Dynamic Fine-Tuning (DFT) to correct it at the token level. However, DFT assumes all demonstrations are equally suitable learning targets, an assumption violated by the strong heterogeneity of large-scale instruction data, where demonstration-policy mismatch induces high-variance updates at the sample level. We introduce Compatibility-Aware Dynamic Fine-Tuning (CADFT), a principled extension of DFT that controls sample-level optimization variance. CADFT derives a dynamic, policy-dependent compatibility signal from model likelihoods to modulate supervised updates, suppressing high-variance gradients from incompatible demonstrations. We further propose a delayed, low-frequency compatibility-guided rewriting strategy to transform persistently incompatible demonstrations into learnable targets. We show that CADFT can be interpreted as a variance-controlled estimator that generalizes token-level stabilization in DFT to the sample level. Extensive experiments demonstrate improved stability, generalization, and cold-start reinforcement learning initialization, while remaining fully supervised and independent of explicit reward modeling.

02.
medRxiv (Medicine) 2026-06-15

Quality Improvement Based Implementation and Evaluation of a Decision Aid for Patients with Nephrolithiasis

Introduction Patients with nephrolithiasis face challenges in making a high-quality, preference sensitive decision. Our prior work established feasibility and patient acceptance of a software-based decision aid (DA). The objectives for this study were to identify implementation strategies for the DA in routine care and determine whether DA implementation enhances decisional quality for patients. Methods New nephrolithiasis patients were recruited from the institution Medical Center from June 2018 to April 2024 to receive a software-based pre-visit DA that measured care preferences and used decision analysis to rank treatments. The RE-AIM framework and Plan-Do-Study-Act (PDSA) cycles were used to improve implementation outcomes. Patients completed survey instruments evaluating decisional conflict, shared decision-making, care satisfaction, and treatment choice following their provider visit. These metrics were compared in the DA cohort (n=81) to those in a usual care cohort (n=78) with Wilcoxon rank-sum and Chi-square (or Fishers exact) tests. Results Implementation data revealed sustained reach and progressive improvement in fidelity. The DA cohort reported higher decisional quality relative to controls (p=0.003) and reported greater support/advice to make a choice (p=0.005). The DA cohort more often discussed options with their doctor (87.5% vs 69.2%, p=0.005) and were more likely to be promoters of their provider (p

03.
arXiv (CS.LG) 2026-06-11

OmniLoc: A Geometry-Aware Foundation Model for Anchor-Free UE Localization Across Diverse Indoor Environments

arXiv:2606.11490v1 Announce Type: new Abstract: Indoor localization from wireless measurements remains challenging in large-scale deployments due to substantial variation in building geometry, the set of detectable access points (APs), and the heterogeneity of received signals. Existing learning-based methods often perform well only in limited settings and degrade under environmental shifts, making robust anchor-free localization across diverse indoor environments notoriously difficult. In this paper, we present OmniLoc, an environment-interactive foundation model for anchor-free user equipment localization across diverse indoor environments. To the best of our knowledge, OmniLoc is the first foundation-model-based approach built directly on wireless measurements for this task. OmniLoc is built on three key designs. First, a unified input tokenization module converts heterogeneous wireless measurements into a common representation that is more amenable to learning. Second, a geometry-aware Transformer performs AP-aware feature extraction by emphasizing dominant APs while aggregating complementary evidence from supporting APs. Third, a geometry-aware location estimation module conditions regression on geometric embeddings to produce geometrically consistent location predictions. We evaluate OmniLoc on both a large-scale in-house dataset and a public benchmark dataset. Results show that OmniLoc significantly outperforms existing methods, consistently improves existing backbones when its design components are integrated, and demonstrates strong generalization in cross-environment evaluations.

04.
arXiv (CS.LG) 2026-06-11

Intermittent time series forecasting: local vs global models

arXiv:2601.14031v2 Announce Type: replace-cross Abstract: Forecasting intermittent time series, which contain zeros, is a crucial challenge in supply chains as inventory policies require probabilistic forecasts to establish safety levels. Intermittent time series are commonly forecast using local models, trained individually on each time series. In the last years global models, trained on a large collection of time series, have become popular for time series forecasting. Global models are often based on neural networks or gradient boosted trees. We carry out the first study comparing state-of-the-art probabilistic local and global models on intermittent time series. For global models we consider three different distribution heads suitable for intermittent time series: negative binomial, hurdle-shifted negative binomial and Tweedie. To the best of our knowledge, this is the first use of the latter two with neural networks. We perform experiments on five datasets comprising overall more than 40'000 real-world time series. Among global models, TiDE, a simple neural network architecture, achieves the best accuracy; it also consistently outperforms local models and has lower computational requirements. Large global models are instead much more computationally demanding and less accurate. Among the distribution heads, the Tweedie provides the best estimates of the highest quantiles.

05.
arXiv (CS.CV) 2026-06-24

3D Masked Autoencoders are Robust Learners of Volumetric and Multimodal Cellular Representations for Microscopy

Self-supervised learning in fluorescence microscopy often relies on 2D projections, despite the inherently three-dimensional nature of cells. We present a systematic comparison of 2D and 3D masked autoencoders (MAE-2D vs. MAE-3D) on volumetric microscopy data. Under matched architectures and training protocols, MAE-3D consistently outperforms 2D max-projection and slice-based variants on downstream single-cell tasks. We further align visual representations with a pretrained protein language model (ESM2) and show that cross-modal supervision yields larger gains for volumetric models. Channel cross-attention and frequency-domain regularization are critical for leveraging 3D spatial context. On a protein–protein interaction task, MAE-3D achieves a ROC–AUC of 0.865, outperforming prior methods by up to +0.025. For protein localization, our best 3D model attains state-of-the-art AUC$_{micro}$ (0.952) and F1$_{micro}$ (0.742), improving over previous approaches by +0.003 and +0.010 absolute, respectively. Overall, these results demonstrate the advantages of native 3D modeling and multimodal alignment for representation learning in single-cell microscopy.

06.
arXiv (CS.AI) 2026-06-17

Multiple cyclicity and Wavelet Decomposition with Channel Correlation for Long-term Time Series Forecasting

arXiv:2606.17996v1 Announce Type: cross Abstract: Cyclicity and trend are important components of time series data and many studies based on cyclicity and trend have achieved good results in long-term time series forecasting. However, we believe that current work neglects the influence of real-world inter-channel correlations in time series data which leads to suboptimal predictions. Furthermore, these models rely on complex designs to capture diverse information so that resulting in low computational efficiency. To address this challenge, we propose McWC, a long-term time series forecasting model that separately models the cyclicity, trend, and inter-channel correlations. Specifically, McWC first decouples cyclical information from data using a multi-layer cyclicity construction module. Then, it extracts inter-channel correlations using multi-layer perceptron. Next, it models and fuses the multi-layer high-frequency and low-frequency information from data using a multi-level wavelet decomposition module. Finally, it aggregates the results of different components to obtain the output. Simultaneously, we decouple intra-channel autocorrelations by calculating a loss function in the frequency domain. Experiments on six real-world datasets demonstrate that McWC achieves state-of-the-art performance, exhibiting excellent computational efficiency and historical information extraction capabilities.

07.
arXiv (CS.AI) 2026-06-15

Hybrid Open-Ended Tri-Evolution Makes Better Deep Researcher

arXiv:2606.13710v1 Announce Type: new Abstract: Deep research and agent evolution serve as de-facto tasks for AI agents in real-world applications toward artificial general intelligence. The former enables autonomous retrieval and integration of information in open-ended environments to tackle open-ended research tasks, yet it is constrained by the static parametric deep research capabilities of agent systems. The latter allows agents to autonomously interact with the environment to gain experiences that evolve model capabilities. However, its effectiveness has been widely validated only on verifiable tasks with standard answers, leaving a gap with open-ended research tasks. To bridge these two critical tasks, we propose the Hybrid Open-Ended Tri-Evolution (HOTE) framework, which leverages hybrid-mode reinforcement learning to facilitate the collaborative evolution of a proposer, solver and judge based on web-scale knowledge, moving toward autonomous evolving agents in open-ended tasks and environments. Extensive experiments on three long-form deep research benchmarks demonstrate that the 8B model trained via HOTE surpasses the strongest static open 8-32B models as well as those trained by state-of-the-art deep research training methods with less time overhead, and further verify that the evolution of all three modules in HOTE is indispensable.

08.
arXiv (math.PR) 2026-06-15

Ergodicity for stochastic 2D Boussinesq equations with a highly degenerate pure jump Levy noise

arXiv:2503.18045v2 Announce Type: replace Abstract: This study aims to analyze the ergodicity for stochastic 2D Boussinesq equations and explore the impact of a highly degenerate pure jump L\'{e}vy noise acting only in the temperature equation, where this noise could appear on only a few Fourier modes. By leveraging the equi-continuity of the semigroup established through Malliavin calculus and an analysis of stochastic calculus, together with the weak irreducibility of the solution process, we prove the existence and uniqueness of the invariant measure. Moreover, we overcome the main challenge of establishing time asymptotic smoothing properties of the Markovian dynamics corresponding to this system by conducting spectral analysis of the Malliavin covariance matrix.

09.
arXiv (math.PR) 2026-06-16

Uniform integrability of the distance to the nearest leaf in random trees

arXiv:2606.15339v1 Announce Type: new Abstract: We study the distance from the root to the nearest leaf, the analogous quantity for a uniformly chosen vertex, and its protection number, in size-conditioned simply generated trees. We prove a uniform exponential tail bound for each of these quantities, valid for arbitrary offspring distributions. As a consequence, these random variables are uniformly integrable of every order. This yields convergence of all moments to those of the corresponding local limit. The argument is probabilistic and unified across the three quantities.

10.
arXiv (math.PR) 2026-06-17

Convergence rate of Euler–Maruyama scheme to the invariant probability measure under total variation distance for the SDEs

arXiv:2505.04218v3 Announce Type: replace Abstract: This article shows the geometric decay rate of Euler-Maruyama scheme for one-dimensional stochastic differential equation towards its invariant probability measure under total variation distance. Firstly, the existence and uniqueness of invariant probability measure and the uniform geometric ergodicity of the chain are studied through introduction of non-atomic Markov chains. Secondly, the equivalent conditions for uniform geometric ergodicity of the chain are discovered, by constructing a split Markov chain based on the original Euler-Maruyama scheme.

11.
arXiv (CS.CV) 2026-06-16

Enabling Real-Time Point-of-Care Ultrasound Segmentation: A GPU-Free Deployment in Resource-Limited Settings

Authors:

Ultrasound imaging is the most widely adopted medical modality globally due to its low cost and portability, yet artificial intelligence (AI) deployment remains constrained by reliance on GPU-accelerated models, creating a structural paradox where the cost of "intelligence" exceeds that of the imaging device itself. Here, we present the systematic adaptation and extensive evaluation of UltraSeg, an ultra-lightweight architecture originally developed for colonoscopic polyp segmentation, now engineered for point-of-care ultrasound (POCUS) across ten public datasets spanning six anatomical sites (breast, thyroid, kidney, carotid, fetal, and small-animal tumor). We systematically validate both variants in ultrasound domains: UltraSeg-130K (0.13M parameters) achieves 89.7 FPS on single-core CPUs and 34.8 FPS on a refurbished mobile device, while UltraSeg-500K (0.5M parameters) delivers 44.6 FPS on CPU and 16.1 FPS on mobile device. UltraSeg-500K matches or exceeds the Dice performance of the 31M-parameter UNet and approaches 105M-parameter TransUNet in average performance, with superior zero-shot cross-dataset generalization on external validation sets (UDIAT, DDTI). By enabling clinical-grade segmentation without GPU dependency, this work brings AI costs in line with ultrasound accessibility, making advanced diagnostics available in resource-limited settings.

12.
arXiv (CS.CL) 2026-06-24

Few shot chain-of-thought driven reasoning to prompt LLMs for open ended medical question answering

In this paper, we propose a modified version of the MedQA-USMLE dataset, named MEDQA-OPEN, which contains open-ended medical questions without options to mimic clinical scenarios, along with clinician-approved reasoned answers. Additionally, we implement a prompt driven by Chain of Thought (CoT) reasoning, CLINICR, to mirror the prospective process of incremental reasoning, reaching a correct response to medical questions. We empirically demonstrate how CLINICR outperforms the state-of-the-art 5-shot CoT-based prompt (Liévin et al., 2022). We also present an approach that mirrors real-life clinical practice by first exploring multiple differential diagnoses through MCQ-CLINICR and subsequently narrowing down to a final diagnosis using MCQ-ELIMINATIVE. Finally, emphasizing the importance of response verification in medical settings, we utilize a reward model mechanism, replacing the elimination process performed by MCQ-ELIMINATIVE.

13.
arXiv (CS.AI) 2026-06-12

Speculative Rollback Correction for Quality-Diverse Web Agent Imitation

arXiv:2606.12485v1 Announce Type: cross Abstract: Training interactive web agents through imitation learning from expert trajectories has emerged as a highly effective approach. However, determining the optimal timing for expert intervention presents a critical challenge in this context. Delayed intervention often leads to the accumulation of early-stage errors, pushing the page state into an irrecoverable regime. Conversely, premature or excessive intervention causes the agent to become overly reliant on expert policies, trapping the model in local optima characterized by a single, rigid trajectory. We propose Speculative Rollback Correction (SRC), a branch-level imitation framework for resettable agent environments. Instead of requesting teacher labels at every visited state or correcting only after a completed trajectory, SRC uses fixed-horizon branch review: the student executes a short speculative segment before teacher review, and the teacher localizes the first harmful deviation only when local progress breaks. Rollback preserves useful prefixes, while successful rollouts are filtered by a hard verifier and retained in a lightweight quality-diversity archive. The resulting data supports next-action supervised fine-tuning on both localized corrections and verifier-passing trajectories. On WebArena-Infinity, SRC collects 977 verifier-passing trajectories and 9,183 next-action examples; fixed-horizon review improves the recovery-versus-query tradeoff over step-level review while retaining verifier-passing solution variants. Code is available at https://github.com/LongkunHao/SRC_gui_agent.

14.
arXiv (CS.CL) 2026-06-16

Speaking the Language of Science: Toward a General-Purpose Generative Foundation Model for the Natural Sciences

In this report, we present LOGOS (Language Of Generative Objects in Science), a scientific generative language model that unifies heterogeneous tasks across the natural sciences within a single autoregressive framework based on a shared scientific grammar. It encodes diverse scientific objects and their spatial interactions as token sequences over a common vocabulary. By representing spatial contact and constraint patterns as discrete tokens, the model captures complex structural interactions in a purely sequential manner, without relying on explicit coordinates or geometric neural networks. This unified representation enables a wide range of downstream tasks to be formulated consistently as next-token prediction in the same grammar space, creating strong alignment between continued multi-domain pre-training and downstream objectives. Across diverse tasks, LOGOS consistently matches or outperforms domain-specific baselines, providing preliminary evidence for the feasibility of "one model fits all" in the natural sciences. We train LOGOS models at different scales (1B, 3B, and 8B parameters) and find a consistent positive correlation between model size and performance. This suggests that the future of AI for Science (AI4S) may not lie in building an independent technical stack that is separated from large language models (LLMs). Instead, it may depend on deeply aligning scientific foundation models with LLMs through shared architectures, shared training paradigms, and shared inference infrastructure, so that LLMs can truly become a new entry point for AI4S. We release the model weights and associated resources to facilitate further research.

15.
bioRxiv (Bioinfo) 2026-06-20

Systematic Evaluation of Feature Representations for Cancer-Associated sORF Prediction in Non-coding RNA

Short open reading frames (sORFs) within non-coding RNAs (ncRNAs) have arisen as a hidden layer of gene regulation, encoding small peptides that represent a new class of cancer regulators with diagnostic and therapeutic potential. However, inferring associations between sORFs to specific cancer types remains challenging and requires computational approaches for accurate prediction. Recently, the CoraL framework introduced the first computational approach for predicting cancer-associated peptides, focusing primarily on model architecture while overlooking how feature extraction strategies influence predictive accuracy. We present a systematic evaluation of machine learning models and feature extraction approaches to predict cancer-associated sORFs across 15 cancer types. We benchmarked seven traditional machine learning algorithms combined with three feature extraction methods: k-mer frequency, Word2Vec embeddings, and genomic language model (gLM)-based embeddings. To our knowledge, this is the first study applying gLM-derived embeddings to the prediction of cancer-associated sORFs in ncRNA. Our results show that traditional machine learning models with appropriate feature extraction outperform the CoraL baseline across all cancer types, achieving up to 10% higher accuracy in some of the 15 evaluated datasets. Interestingly, k-mer features consistently outperformed gLM embeddings without fine-tuning, suggesting that local sequence composition may provide more discriminative information for this task and that pre-trained genomic representations may require task-specific adaptation to fully capture these patterns. Additionally, we observed that the way sequences are tokenized, such as the k-mer length, can affect performance: longer fragments (e.g., k=7) sometimes reduced accuracy for Random Forest but had a smaller effect on MLP. Our findings suggest that appropriate feature engineering can provide greater improvements than increasing model complexity.

16.
arXiv (CS.CV) 2026-06-17

GeoDisaster: Benchmarking Orchestrated Agents for Operational Disaster Geo-Intelligence

Remote-sensing vision-language models (RS-VLMs) have advanced Earth-observation analysis toward visual interpretation and instruction-following, yet fall short of operational geo-intelligence, which demands tool-grounded spatial reasoning and structured, evidence-backed decisions. We introduce GeoDisaster, an operational geospatial disaster reasoning benchmark with 2,921 verified instances across 43 question types and five task families: deforestation monitoring, multi-hazard analysis, building-damage assessment, flood-safe routing, and Sentinel-1 SAR flood monitoring. Instances integrate heterogeneous EO/GIS evidence-optical and SAR imagery, raster masks, vector geometries, road networks, and exposure layers-spanning hazard detection, damage assessment, exposure estimation, and diagnostic report generation. Ground-truth answers are grounded in executable geospatial workflows and deterministic consistency checks, removing the need for language-model annotation. We further propose an orchestrated multi-agent framework with 18 disaster-oriented tools, where role-specialized agents coordinate through explicit execution contracts, aligned via Role-Contract Expectation Alignment (RCEA): failure-aware supervised fine-tuning combined with contract-grounded reinforcement learning over dense step-level signals. Experiments show that GeoDisaster challenges existing RS-VLMs and agentic systems, while RCEA improves tool use, evidence grounding, state consistency, and decision generation.

17.
arXiv (CS.AI) 2026-06-11

Conformal Risk-Averse Decision Making with Action Conditional Guarantee

arXiv:2606.05551v2 Announce Type: replace-cross Abstract: Reliable decision making pipelines powered by machine learning models require uncertainty quantification (UQ) methods that come with explicit safety guarantees. Conformal prediction provides such UQ by wrapping ML predictions into prediction sets, and recent work by Kiyani et al. (2025b) established that these sets can be translated into optimal risk-averse decision policies – yet only inheriting marginal safety guarantees. We generalize and strengthen their results by (i) introducing action-conditional conformal prediction, which yields safety guarantees conditioned explicitly on each action taken by the decision maker, (ii) showing that action-conditional prediction sets serve as a proxy for the feasible decision space for risk-averse decision makers aiming to optimize action-conditional value-at-risk, and (iii) proposing a principled finite-sample algorithm based on pinball-loss minimization, connecting the framework of Gibbs et al. (2025) to action-conditional guarantees. Experiments on two real-world datasets confirm that our approach significantly improves action-conditional performance over conformal baselines.

18.
arXiv (CS.AI) 2026-06-11

Improving Detection of Rare Nodes in Hierarchical Multi-Label Learning

arXiv:2602.08986v2 Announce Type: replace-cross Abstract: In hierarchical multi-label classification, a persistent challenge is enabling model predictions to reach deeper levels of the hierarchy for more detailed or fine-grained classifications. This difficulty partly arises from the natural rarity of certain classes (or hierarchical nodes) and the hierarchical constraint that ensures child nodes are almost always less frequent than their parents. To address this, we propose a weighted loss objective for neural networks that combines node-wise imbalance weighting with focal weighting components, the latter leveraging modern quantification of ensemble uncertainties. By emphasizing rare nodes rather than rare observations (data points), and focusing on uncertain nodes for each model output distribution during training, we observe improvements in recall by up to a factor of five on benchmark datasets, along with statistically significant gains in $F_{1}$ score. We also show our approach aids convolutional networks on challenging tasks, as in situations with suboptimal encoders or limited data.

19.
arXiv (CS.AI) 2026-06-16

Fast LLM-Based Semantic Filtering: From a Unified Framework to an Adaptive Two-Phase Method

arXiv:2606.08090v2 Announce Type: replace-cross Abstract: Evaluating a natural-language yes/no predicate over a document corpus under an accuracy target - the semantic filter - is a cornerstone of LLM-based data processing. Calling the LLM on every document (the oracle) is prohibitive, so cascades pair the oracle with a fast proxy. As deployed today, they leave four limitations on the table. (1) Each cascade family - model-free clustering, prebuilt small-LLM proxies, online-trained proxies - commits to a single representation and pipeline, and wins on only a narrow query regime. (2) The strongest online proxy invests in a custom training scheme on a bi-encoder over dense embeddings, missing the token-level evidence richer predicates require. (3) The proxy is trained against binary yes/no labels, wasting the LLM's per-document confidence at the boundary documents it most needs to learn. (4) Existing calibrations add a uniform safety margin, conflating genuine proxy uncertainty with small-sample noise and inflating cascade cost. We address these by (1) composing families adaptively - model-free clustering first, online proxy only when needed, with oracle calls shared across phases; (2) replacing the cosine bi-encoder with a hybrid of off-the-shelf token-aware models; (3) training the proxy with the oracle's per-document confidence as a soft label; and (4) a calibration that adds the safety margin only where the labeled sample is sparse. We are also the first to use the oracle's per-document confidence for three purposes: a query-level difficulty compass, a lower bound on the minimum oracle calls any proxy-based cascade can make, and the proxy's soft training label. At a 90% accuracy target on three 10K-document corpora, our methods are 1.6-2.0x faster than the best prior method per corpus and meet the target on 95% of queries; the BER-derived lower bound indicates a further ~4-20x of headroom for future work.

20.
arXiv (CS.CV) 2026-06-17

m2sv: A Scalable Benchmark for Map-to-Street-View Spatial Reasoning

Vision–language models (VLMs) achieve strong performance on many multimodal benchmarks but remain brittle on spatial reasoning tasks that require aligning abstract overhead representations with egocentric views. We introduce m2sv, a scalable benchmark for map-to-street-view spatial reasoning that asks models to infer camera viewing direction by aligning a north-up overhead map with a Street View image captured at the same real-world intersection. We release m2sv-20k, a geographically diverse benchmark with controlled ambiguity, along with m2sv-sft-11k, a curated set of structured reasoning traces for supervised fine-tuning. Despite strong performance on existing multimodal benchmarks, the best evaluated VLM achieves only 65.2% accuracy on m2sv, below human annotators who reach 72.0% on average (and 95% for an expert) with strong inter-annotator agreement ($\kappa$ up to 0.76). While supervised fine-tuning and reinforcement learning yield consistent gains, cross-benchmark evaluations reveal limited transfer. Beyond aggregate accuracy, we systematically analyze difficulty in map-to-street-view reasoning using both structural signals and human effort, and conduct an extensive failure analysis of adapted open models. Our findings highlight persistent gaps in geometric alignment, evidence aggregation, and reasoning consistency, motivating future work on grounded spatial reasoning across viewpoints.

22.
arXiv (quant-ph) 2026-06-16

Noise-induced shallow circuits and absence of barren plateaus

arXiv:2403.13927v3 Announce Type: replace Abstract: Motivated by realistic hardware considerations of the pre-fault-tolerant era, we comprehensively study the impact of uncorrected noise on quantum circuits. We first show that in the task of estimating observable expectation values any noise truncates most quantum circuits to effectively logarithmic depth. We then prove that quantum circuits under any non-unital noise do not exhibit barren plateaus for cost functions composed of local observables. However, by using the effective shallowness, we also design an efficient classical algorithm to estimate observable expectation values within any constant additive accuracy, with high probability over the choice of the circuit, in any circuit architecture. Taken together, our results establish that, unless we carefully engineer quantum circuits to take advantage of the noise, noisy quantum circuits are unlikely to offer an advantage over shallow ones for algorithms that output observable expectation value estimates, such as many variational quantum machine learning proposals.

23.
arXiv (CS.CL) 2026-06-17

AIPatient Arena: EHR-grounded evaluation of large language models in end-to-end clinical consultation workflows

Large language models (LLMs) are increasingly considered for use in clinical consultation tasks, yet most medical evaluations remain static, single-turn, or narrowly outcome-based, limiting their ability to reflect the sequential, uncertain, and interactive nature of real-world care. Here, we propose AIPatient Arena, an EHRs-grounded evaluation framework for assessing the clinical utility of LLMs across eight dimensions of clinical competence. The framework integrates EHR data into patient-specific knowledge graphs, enabling multi-turn physician-patient interactions. We applied AIPatient Arena on a primary cohort of 437 patients and two out-of-distribution validation cohorts of 119 and 67 patients. We observe that LLMs performed well in medical interview questioning skills (QS; mean scores, 4.43-4.99/5), ethical and professional conduct (ET; 4.38-4.93/5), and clarity and transparency of clinical explanations (EX; 3.80-4.72/5). Performance was moderate in information integration (II; 3.19-4.21/5) and medication safety and justification (MS; 3.13-3.78/5), but persistent weaknesses were observed in handling of ambiguous patient responses (HR; 2.57-3.32/5), information coverage (IC; 2.08-3.02/5), and diagnostic accuracy and reasoning (Dx; 2.63-3.55/5). Process-based evaluation revealed recurrent interaction failures, including repetitive questioning, omission of past medical history, and inadequate handling of uncertainty. Richer conversational context improved diagnostic reasoning but yielded limited gains in treatment planning. These findings indicate that final-answer accuracy alone is insufficient for evaluating clinical readiness and highlight the importance of assessing how models gather, interpret, and communicate information throughout a consultation. AIPatient Arena provides an EHR-grounded framework for workflow-oriented pre-deployment evaluation of medical LLMs.

24.
medRxiv (Medicine) 2026-06-11

Neighborhood socioeconomic status associated with post-stroke cognitive impairment: a retrospective cohort study

Background: Late complications after stroke (LCAS), including cognitive symptoms, impact quality of life and recovery. It is not known if neighborhood-level measures of socioeconomic status (SES) influence LCAS. This study assessed associations between SES measures, including neighborhood income inequality (Gini) and area deprivation index (ADI), and cognitive symptoms after acute ischemic stroke (AIS) in a hospital leveraging active surveillance of LCAS. Methods: This retrospective cohort study included 512 patients hospitalized with AIS at Tufts Medical Center with subsequent follow-up (between zero and three months or between three and twelve months) in the Stroke Clinic from 1/1/2018 - 12/31/2022. Using ZIP code data, patients were characterized as low Gini (low inequality) and high ADI (high deprivation) (Gini = 5) by state medians. These variables were combined, indicating patients who were living in both a low Gini and high ADI neighborhood to evaluate the effects of living in a homogeneously deprived area. There were 206 and 281 patients in the low Gini and high ADI groups respectively. 140 patients lived in a low Gini and high ADI neighborhood. The multivariable logistic analysis assessed the likelihood of cognitive symptoms, adjusting for age, race, ethnicity, sex, NIH Stroke Scale (NIHSS), thrombolysis, active LCAS surveillance, poverty, and ADI-Gini combination. Results: There were no associations between high ADI (OR: 1.03, 95% CI: 0.67 ? 1.57) or low Gini (OR: 1.74, 95% CI: 0.98 ? 3.07) alone and cognitive symptoms after AIS. However, the combined variable demonstrated increased likelihood of cognitive symptoms in the high ADI-low Gini group (OR: 1.82, 95% CI: 1.08 ? 3.06). Conclusions: This study suggests that individuals living in homogeneously deprived neighborhoods report higher likelihood of cognitive symptoms after AIS. Further studies with increased power are needed to investigate the underlying causes of these disparities and to develop interventions to reduce these complications.

25.
arXiv (quant-ph) 2026-06-11

Fun with Graph States: Nonlocal Bell Pairs and the Arf Invariant

arXiv:2606.06582v2 Announce Type: replace Abstract: We study inner products and partial amplitudes of graph states–a commonly employed class of quantum states, which are specified by graphs. We find that the magnitudes of these quantities are simply related to the rank of the adjacency matrix of the graph over F_2 while the phase is determined by the Arf invariant of its quadratic refinement. These facts motivate a nonlocal tensor factorization of the Hilbert space, with respect to which all graph states are products of Bell pairs with unentangled ancillae. These results may illuminate the quantum advantage in the framework of Measurement-Based Quantum Computation and suggest that graph states can be usefully visualized in the language of algebraic topology. In addition, we develop a specialized technique for computing expectation values of qubit-wise permutations in graph states, which is useful for calculating multi-invariants.